Agenda item

Councillor Brian Ford (Cabinet Member for Adults and Health), was in attendance and presented to the Committee a report summarising progress and performance in respect of his portfolio of responsibility.

The Committee noted that the key objectives and role of the Cabinet Member for Adults and Health is to:

·       Provide strategic and political leadership for the provision of Adult Social Care.

·       To work with other Cabinet Members to Manage Demand within the portfolio.

·       Ensure the strategic framework is in place to deliver:

a)    adults’ safeguarding

b)    services for those with learning difficulties

c)     joint working with health

d)    public health services

·       Ensure that the Council's agreed priorities within the portfolio are delivered.

The Committee noted that the Cabinet Member for Adults and Health has the following delegated responsibilities:

·       Adult Services (older people, people with a learning disability, physical disabilities, and mental health).

·       Adult Voluntary Sector Contracts.

·       Implementation of Care Act 2014.

·       Adult Local Safeguarding Board.

·       Public Health – including health promotion and health and wellbeing services.

·       Supported Housing.

·       Learning Disability Partnership Board.

·       Maintaining links between the Council and partner organisations in the Health Services.

·       Oversight of Better Care Fund and integration with Adult Social Care (ASC) and Clinical Commissioning Group Funding (CCG).

·       Mental Health Champion - The Local Authority Mental Health Challenge.

The Committee noted that, in overseeing these areas, the Cabinet Member for Adults and Health is responsible for Swindon’s priority to help people to help themselves while always protecting the most vulnerable children and adults (Priority 4). The pledges committed to include:

·       Pledge 12. Work with partners to promote healthy lifestyles for the population of Swindon.

·       Pledge 18. Deliver a borough-wide approach to increase the impact of volunteering, enabling more people to be active in supporting vulnerable people.

·       Pledge 19. Ensure that more people and their carers are supported to live as independently as possible and reduce the length of time people need to spend in residential care. This will be achieved through work with the Clinical Commissioning Group and GP surgeries to help people with long term health and social care needs to manage their health effectively with support from community groups and multi-disciplinary teams.

·       Pledge 23. Ensure that Swindon’s vulnerable adults are safeguarded and protected.

·       Pledge 24. Increase the number of organisations in Swindon working to achieve ‘Dementia Friendly’ Town Status for Swindon and ensure annual accreditation.

·       Pledge 30. Reduce smoking prevalence to less than the England average.

Councillor Ford, assisted by the Corporate Director for Adult Social Services and the Interim Director of Public Health, responded to questions and comments put by Councillors Steve Allsopp,Nick Martin, Brian Mattock, Des Moffatt, Bazil Solomon,Timothy Swinyard and the Chair on the following matters:

·       The responsibilities of, and relationships between, Swindon Borough Council, Great Western Hospital (GWH), and the Swindon Clinical Commissioning Group (CCG). The Committee noted that the Council works with GWH and the CCG at a macro level, and assists released patients with personal support, not clinical support. It does this by commissioning external organisations to provide services, and by working closely with the voluntary and community sector.

·       The ongoing work of the Sustainability and Transformation Partnership Board to combine the CCGs currently covering Bath and North East Somerset, Wiltshire and Swindon. The Cabinet Member advised that he is a member of this Board, and is working to ensure there remains a focus on Swindon. 

·       The improvements in delayed transfer of care as a result of the integrated approach adopted by the Council and GWH, and how the amalgamation of the CCGs will not have an impact on this.

·       The barriers that working with a larger CCG organisation may create, and the subsequent affect it may have on the ability of officers to build relationships and effect change at a local level. 

·       The influence the Council has over the primary care offer in Swindon, and its involvement during the recent problems experienced when the IMH Group took on responsibility for the running of a group of GP Surgeries. 

·       The allocation of resources for Swindon under the amalgamated CCG structure, and how an equitable distribution across the areas will be ensured.

·       The processes in place between GWH and the Council to assist in the efficient and timely discharge of patients, including the two Council teams based on site and the daily phone calls amongst senior officers at both organisations.

·       The Council’s relationship with the Police on the adult safeguarding cases where domestic abuse has been indicated on the referral form.

·       The change of management at the Swindon Women’s Aid Centre, which is a commissioned service of the Council, and the Council’s involvement in the recruitment process.

·       Further expected integration with the CCG, including the co-locating and co-financing of services, which will be the subject of a Cabinet report in the near future. 

·       The involvement of Public Health in planning generally, with the Local Plan Review in particular, and also within the designs for houses being built by the Council’s Housing Management Company, to influence the built environment by future proofing and reducing difficulties as part of good design practice.

·       The high prevalence of diabetes in Swindon, and the attendance of residents on the diabetes education programme which began in early 2019. The Committee noted that this is the responsibility of the CCG, and its programme of diabetes transformation had been commissioned using analytics on diabetic care and had been modelled on best practise from across the country. Early indications show that education on diabetes has improved as a result of the programme.

·       The relationship between diabetes and other issues, such as mental health, and the help and support offered within Swindon on diabetes prevention and education for those already living with the disease. 

·       The national problem of recruiting Doctors to primary care positions, and how this is being demonstrated at a local level in Swindon with the recent IMH Group issues.

·       The consideration of loneliness as a ‘deprivation’, and the agenda for reducing this across Swindon.

·       The availability of funding to continue work on prevention strategies, whilst maintaining the same level of results, across Public Health and Adult Social Care.

·       The numbers of private care home places currently available in Swindon.

·       The complex relationship between wealth and health.

·       The revision of Public Health plans to make use of available investment, and the potential impact that a lack of staff in this sector could have on the success of those plans.

·       The geographical distribution of courses across Swindon which assist people in improving their balance.

·       The sustainability of the social care sector should there be a no-deal Brexit, and the impact on non-nationals working in the sector. The Committee noted that guidance has been given to providers to make staff and residents aware of the need to acquire Settled Status. The issue will also be addressed in business continuity plans. 

·       How residents connect with Public Health and other providers / organisations, and receive feedback on concerns. The Adults’ Health, Adults’ Care and Housing Overview and Scrutiny Committee will be invited to consider the work of the Health and Wellbeing Board, how issues are raised with the Board, and the process residents can use through Healthwatch, the Patient Advice Liaison Service, and the Integrated Care Alliance Board.

·       The safeguarding issues around the dispensing, collection, and disposal of used needles, and how this will be included in the report to be considered by the Adults’ Health, Adults’ Care and Housing Overview and Scrutiny Committee in the 2019/2020 Municipal Year.

·       The work being done on the prevention of suicides, including a refresh of the Suicide Prevention Strategy and a needs assessment, which will be incorporated along with equalities issues as part of the report to be considered by the Health and Wellbeing Board in the 2019/2020 Municipal Year. 

Resolved – (1) That Councillor Ford be thanked for attending the meeting to present his performance report and for his full and open responses to members’ questions and observations on the issues raised.

(2) That information requested by members during the course of the Committee’s consideration of this item be forwarded to them via the Committee Clerk.

(3) To invite the Adults’ Health, Adults’ Care and Housing Overview and Scrutiny Committee to add a report to its Work Programme for the 2019/2020 Municipal Year on the involvement of residents with the adult social care sector in Swindon.